Cryotherapy or Cold Therapy
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Ice and cold therapy is a widely used treatment technique employed routinely by physiotherapists in the management of acute and chronic conditions of various types. It is a relatively safe treatment and simple to apply, with patient instruction usually successful in self managing their injuries or pains with this method. Physiotherapists will know the contraindications and indications for using this therapy and use this method commonly in acute injuries and sporting injuries as it is effective, easy and cheap to use. Different techniques can be used such as cold water immersion, cubed ice, crushed ice or cold packs.
Ice therapy cools the local tissues by carrying away heat from the body as the ice melts or the cold water warms. The main physiological effects of cold therapy include decreasing the local metabolism, vasoconstriction, circulation increase in reaction to cold, reduction in oedema and swelling, decrease of any haemorrhage, reduction in muscle efficiency and analgesia secondary to sedation of nerve transmission from the cold. Muscle spasm and spasticity are also reduced as a side effect of pain reduction from the cold application.
There are many tissue based effects which are promoted by the application of cold therapy and these include post-injury reduction of swelling and oedema, a time-related reduction in spasticity once the cold has been applied for some time, an increase in the local circulation, lowering of the acute inflammation which follows tissue damage, muscle spasm reduction, and pain inhibition. Muscle contraction can be facilitated by a physiotherapist using cold therapy and this can be used to improve muscle contraction to increase joint ranges of motion after injury.
Tissue damage from an injury to an area increases the blood supply locally, is hotter and suffers from oedema, all secondary to heightened tissue metabolism as the area reacts to damage. At this early stage these responses need to be damped down so cold is preferred over heat which would increase them. Cold reduces inflammation, eases pain, prevents swelling and slows the metabolic rate of the injured tissues, encouraging injury healing. It is important to get the cold onto the injured part as close to the precipitating event as you can, with compression if possible. Compression has been shown to be effective and may be more important than the cold.
It is important to understand the risks to skin integrity which potentially come with using cold therapy. Contraindications to cold are understood by physiotherapists and they will examine the skin for normal sensibility and good colour with lack of broken or abnormal areas. To protect the skin integrity oil can be applied to the area before cold application. A common treatment is performed using an ice pack, made by packing crushed ice into a towel bag and applied closely to the part to be treated. Thorough wetting of the towel and eliminating any pockets of air between the pack and the skin ensure a good cooling effect.
Convenient and cheap home cold application is often performed using a pack of frozen peas but these should be used with caution as they come out from the freezer at -18 degrees centigrade and this could result in skin injury. This temperature is too low for direct skin application and a wet cloth should always be interposed between the skin and the pack to avoid the chance of frostbite which is cold-mediated local skin damage. From five to twenty minutes is the typical application time used and the skin should be checked after five or ten minutes to make sure skin reaction is normal. Small white spots appearing on the skin indicate overcooling and treatment should stop.
Pain after operative intervention or acute injuries are good subjects for cold therapy in the first two days after onset to control inflammation and pain. Areas of altered skin sensibility should be avoided as they may react abnormally and other contraindications are arterial insufficiency, cold allergy, Reynauds syndrome and lower limb ischaemia. Physiotherapists use various techniques including cold packs, water immersion, contrast baths, spray and stretch and massage with ice. Myofascial pain syndrome trigger points are treated with spray and stretch.
Article Source: Articlelogy.com
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